COLOBREATHE ® PATIENT GUIDE AND INSTRUCTIONS FOR USE
Contents of the pack
The Turbospin® Inhaler
Taking Colobreathe® using the Turbospin® Inhaler
Cleaning the Turbospin® Inhaler
Introduction In this booklet, you will find detailed information on how to load the Colobreathe® Turbospin® inhaler, how to inhale the medication and inspect and clean the device.
About Colobreathe® There are two elements to your Colobreathe® medication: the capsule that contains the actual medication and the Turbospin® inhaler, a device that ensures your medication is delivered right into your lungs where it’s needed.
Contents of the pack Each pack contains 56 capsules containing the medicine in blister strips – enough for 28 days’ treatment. Inhaling antipseudomonal antibiotics is considered to reduce the possible need for intravenous antibiotics in patients with cystic fibrosis who are chronically infected with Pseudomonas aeruginosa.
Taking Colobreathe® The Colobreathe® medication should be inhaled using the Turbospin® inhaler – one capsule in the morning and another in the evening. Ideally there should be a 12-hour gap between doses. Your healthcare professional will supervise your first ever dose of the medication.
To access the capsule, peel the backing foil from the middle.
Never try and push the capsule through the foil as this may break the capsule and spill some of the contents. Each capsule is filled with enough medication for one dose. The medication is a very fine powder designed for inhalation. 4
The Turbospin® Inhaler You should only use the Turbospin® inhaler with Colobreathe®. Do not attempt to take the medication in any other way such as swallowing. Do not use the Turbospin® inhaler for any other medicines. The Turbospin® inhaler is small, light to carry and easy to store. It has six key elements: a piston that is used to puncture the capsules the body of the Turbospin® inhaler the capsule chamber air slits mouthpiece a cap with a convenient clip
Mouthpiece Air slits Chamber Body Piston
Taking Colobreathe® using the Turbospin® inhaler 1.
Remove the cap. It comes away with a gentle pull. 2.
Unscrew the mouthpiece, exposing the chamber of the Turbospin® inhaler. 3.
emove a single capsule from the blister pack. Once you R have removed the capsule it must be used immediately.
ently insert the capsule into the chamber with the G widest end first. No force is required. 5.
Now replace the mouthpiece by screwing it back into place. 6.
To pierce the capsule: •
old the inhaler with the mouthpiece upright, gently push H the piston upwards until the visible line is reached – you will feel resistance at this point and this will lock the capsule in place ready for piercing. Hold that position before continuing to follow through with the piercing. ow, with the capsule locked in place, continue pushing N the piston as far as it will go and then release. he capsule is now pierced and the contents can be T inhaled.
Do not pierce the capsule more than once. You may see a small amount of powder released from the capsule chamber after the capsule is pierced, this is normal. 7
Breathe out slowly. Place the mouthpiece between your lips and teeth. Ensure there is a seal between your lips and the mouthpiece. Take care not to cover the air slits with your fingers or mouth during inhalation.
8. Then, breathe in slowly and deeply through your mouth at a rate sufficient for you to hear or feel the capsule spinning. 9. Remove the Turbospin® inhaler from your mouth and hold your breath for about 10 seconds or for as long as is comfortable, then breathe out slowly. 10. If you do not hear the capsule spinning, the capsule may be stuck in the compartment. If this occurs, you can loosen the capsule by gently tapping the chamber of the inhaler. Do not try to loosen the capsule by repeatedly pressing the piston. If the capsule cannot be loosened and the powder cannot be inhaled, dispose of the broken capsule and any powder remaining in it and use another. 11. Inhale the medicine again by repeating Steps 7 and 8 to ensure you have emptied the capsule. 12. You can check whether the capsule is empty by unscrewing the mouthpiece and checking the capsule. If it is not empty, repeat steps 7, 8 and 9 until you have inhaled all of the contents.
13. Once all the contents have been inhaled, rinse your mouth out well with water and spit it out. 14. When the capsule is empty, unscrew the mouthpiece, then remove and discard the empty capsule.
Additional information when using Colobreathe® As you breathe in slowly, you suck air through the body of the Turbospin inhaler into the capsule chamber. The tiny particles of medication in the capsule are picked up by the airflow and carried on down your airway into your lungs. Occasionally, very small pieces of the capsule shell can get into your mouth or airways. If this happens, you may be able to feel these pieces on your tongue or in your airways. The capsule shell is made of gelatine, which is harmless to humans if swallowed or inhaled. The chances of the capsule breaking into pieces are increased if the capsule is pierced more than once during Step 6.
Cleaning the Turbospin® inhaler The Turbospin® inhaler is maintenance free but it is important to keep it clean. After you have used the device, push the piston in as far as possible a few times while holding the device upside down. Then, clean the chamber with a soft tissue or cotton bud. Never use water. Finally, screw the mouthpiece firmly back onto the device and replace the cap. The Turbospin® inhaler is now ready to be used for your next dose. Once the pack of Colobreathe® is finished, dispose of the packaging and the device. Each new pack contains a device, and the device should not be used for more than the 28 days’ duration of a pack of Colobreathe®. The Turbospin® inhaler should be discarded after 28 days.
Side effects Like all medicines, Colobreathe® may cause side effects although not everyone will experience them. It is also possible that a side effect will be temporary in some patients and more persistent in others. Common side effects include an unpleasant taste which may be experienced immediately after inhalation. So it is important to rinse your mouth out with water after each dose. Some people might experience cough or throat irritation, difficulty in breathing and hoarseness or loss of voice. If these side effects occur it is recommended that you persist with the medication, as it is likely that they will become less of a problem as you continue. They are seen more frequently at the beginning of treatment, and tend to be less bothersome after the first pack of treatment. Headache or balance disorder, ringing or buzzing in the ears may also be experienced.
For a list of all side effects, please look at the in-pack patient instruction leaflet or ask your healthcare professional. If you experience any side effects, you should consult your healthcare professional or pharmacist. Extreme allergic reactions will require urgent medical attention. Also, if you experience dizziness, confusion or have problems with your sight, you should avoid driving or operating dangerous machinery until the symptoms have gone away. If you are receiving other treatments for cystic fibrosis, you should take them in the following order: inhaled bronchodilators chest physiotherapy other inhaled medicines then Colobreathe® However, you should confirm the order of your treatments with your healthcare professional. Once you have taken your dose and cleaned the inhaler, make sure you put the pack away out of reach and sight of children.
Additional information Although Colobreathe® is easy to carry around, you should not expose it to temperatures over 25 degrees Celsius. Colobreathe® should be kept out of the reach and sight of children. Colobreathe® is designed to make taking your medication as quick and as easy as possible. If you have any concerns or you are unsure about any aspect of your medication, you should always consult your healthcare professional or pharmacist. Some patients may experience common side effects. These are only of nuisance value for most patients, with cough decreasing with repeated use of Colobreathe® and should stabilise after the first month. It is important to continue with Colobreathe® unless advised by your healthcare professional.
Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the package leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Forest Laboratories UK Ltd +44 (0) 1322 421 800.
Date of preparation: October 2014 W1804